Author + information
- Received December 18, 1992
- Revision received May 7, 1993
- Accepted July 15, 1993
- Published online December 1, 1993.
- Pier Sergio Saba, MDa,1,
- Mary J. Roman, MD, FACCa,∗,
- Riccardo Pini, MDa,
- Mariane Spitzer, RDMSa,
- Antonello Ganau, MDa and
- Richard B. Devereux, MD, FACCb
- ↵∗Address for correspondence: Dr. Mary J. Roman, Division of Cardiology, Box 222, The New York Hospital-Cornell Medical Center, 525 East 68 Street, New York, New York 10021.
Objectives. The purpose of this was to examine the relation of the arterial pressure waveform to left ventricular and carotid structure.
Background. The pressure waveform in the central arteries is affected by reflection of the pressure wave from the periphery. When reflected waves merge with the incident wave during systole, a late systolic peak and increment in systolic blood pressure are observed. The consequent increase in hemodynamic load may stimulate left ventricular and vascular adaptive changes.
Methods. Sixty-seven normotensive adults were studied by noninvasive techniques. Anatomy and function of the left ventricle and carotid artery were investigated by ultrasonography. Pressure waveforms were recorded by an external tonometer applied to the carotid artery, and waveform shape was expressed by the augmentation index, calculated from the difference between the maximal systolic pressure and that at the infection between early and late systolic pressure peaks divided by the pulse pressure. Subjects were assigned to groups with a dominant early (group 1, augmentation index ≤0) or dominant late systolic peak(group 2, augmentation index >0).
Results.Left ventricular mass index was significantly higher in group 2 than in group1, a difference that persisted after controlling for the confounding effects of gender, age and blood pressure. Carotid wall thickness and regional arterial stiffness were significantly increased in group 2, but differences disappeared in the analysis of covariance for age.
Conclusions. Left ventricular and carotid artery structure are related to the shape of the central waveform. Although the increase in left ventricular mass seen in subjects with a dominant late systolic peak pressure appears to be directly to the shape of the pressure waveform, changes in the structural and physical properties of the carotid artery to be more closely related to the aging process.
↵1 Dr. Saba is the recipient of a research grant from the Regione Autonoma della Sardegna, Italy.
☆ This study was supported in part by Grant HL 18323 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; the Michael Wolk Heart Foundation, New York and the Helen W. Buckner Cardiac Research Fund, New York.
- Received December 18, 1992.
- Revision received May 7, 1993.
- Accepted July 15, 1993.